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Nur 333 Fun 2 > Urinary Elimination (Exam 2) > Flashcards

Urinary Elimination (Exam 2) Flashcards

1
Q

Micturition

A

-Complex process involving bladder, urinary spinchters, and CNS

-Impulses from the brain respond or ignore the urge

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2
Q

Voiding

A

Bladder contraction and urethral sphincter and pelvic floor muscles

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3
Q

Factors Influencing Urinary Elimination

A

-Growth and Development

-Sociocultural factors

-Psychological factors

-Personal habits

-Fluid intake

-Pathological condition

-Surgical procedures

-Diagnostic examinations

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4
Q

Changes in Older Adults: Increased

A

-Bladder irritability

-Bladder contraction during bladder filling

-Risk of urinary incontinence

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5
Q

Changes in older adults: Decreased

A

-Amount of nephrons

-Bladder muscle tone

-Bladder capacity

-Time between initial desire to void and urgent need to void

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6
Q

Urinary Retention

A

-Inability to partially or completely empty the bladder

-Pressure, discomfort, pain

-Can be acute or chronic

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7
Q

How to diagnoses Urinary Retention

A

-Diagnose with Post-Void Residual (PVR)

-Bladder scanner or straight cath

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8
Q

Urinary Tract Infections

A

-Most common type is E-coli

Anywhere along urinary tract. Upper = kidneys. Lower=bladder

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9
Q

Bacteriuria

A

-Bacteria in the urine

-Does not mean UTI. Can be indicator though

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10
Q

UTI: Risk factors

A

-Presence of indwelling catheter

-Any instrumentation of urinary tract

-Urinary retention

-Fecal incontinence

-Poor hygiene

-Female

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11
Q

Forms of Urinary Incontinence

A

Urgency-Stress-Overflow-Functional

Often multifactorial

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12
Q

Urinary Incontinence: Overflow

A

-Poor bladder emptying or bladder obstruction

-Leaking and dribbling

-Urine stops and starts while peeing

-Males with BPH

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13
Q

Urinary incontinence: Stress

A

-Exertion: Laughing, coughing, sneezing, jumping, changing positions

-Usually women after childbirth

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14
Q

Urinary Incontinence: Urgenecy

A

-Overactive bladder

-Sudden and strong urge to urinate that is hard to delay

-Idopathic and older adults

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15
Q

Urinary Incontinence: Functional

A

Just not being able to get to the bathroom

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16
Q

Incontinecne Risk Factors

A

-More common in women and elderly

-Obesity

-Multiple pregnancies

-Neurological disorders

-Medications

-Confusion

-Dementia

-Immobility

-Depression

17
Q

Assessing for CVA tenderness

A

-Costovertebral Angle

-Testing for Kidney infection

18
Q

Normal Urine Output

A

> 30 mls/hr

19
Q

Concerned about output

A

-If output is <30 mls/hr for 2 hours

-If patient is awake and has gone 6 hours without voiding

20
Q

Urinary Chart

A

Screen shot

21
Q

Urine Testing

A

-Know to collect the urine

-Label appropriately per hospital protocol

-Send as soon as you receive unless it is a timed test

-Know if you need a preservative or not

22
Q

Urinalysis: Nursing Considerations

A

-Must be fresh

-Collect urine normal voiding, indwelling catheter, or urinary diversion

-Must have freshly voided urine

-Cannot take urine from catheter bag

23
Q

Culture and Sensitivity

A

-Can obtain from clean void or clean catch mid stream urine specimen

-Send to lap within 30 min

-Preliminary report should be available within 24 hours

-Use STERILE cup

24
Q

Abdominal Xray: KUB

A

-Determines size, shape, symmetry, location of structures of the urinary tract

-Common uses: (urinary calculi (kidney stone)

-No special Preparation

25
Q

Maintaining Adequate Fluid Intake

A

-2300 mls/day if renal function is ok, no heart disease and no need for fluid restriction

-Helps flush solutes to limit bladder irritability

26
Q

If fluid intake needs increased:

A

-Schedule time to drink

-Fluid Preferences

-High fluid foods (fruits)

-Stop drinking about 2 hours before bedtime to prevent nocturia

27
Q

Incontinence Care

A

-Be respectful of patient feelings

-Pelvic floor muscle training

-Lifestyle changes

-Bladder retraining

-Toileting schedule

-Meticulous skin care

27
Q

Meticulous Skin Care: Do’s

A

-Identify and treat

-use skin risk assessment tool

-Use appropriate skin barrier products

-Ensure adequate hydration

-Consult WOCN if needed

28
Q

Meticulous Skin Care: Don’ts

A

-Use traditional soap and water

-Double padding the bed

-Leave soiled pads

29
Q

Types of Urethral Cathetes

A

Single Lumen (No balloon)

Indwelling catheter (Temp sensing)

3 way / 3 lumen (Bladder irrigation)

Coude tip (Curved rounded) (enlarged prostate)

30
Q

Other types of Catheters: Suprapubic

A

Placed in the bladder through abdominal wall. (Sutured in place) (Used when blockage of urethra or when indwelling catheter causes irritation)

31
Q

Purewick

A

Sits in-between female patient legs and is hooked to genital suction

They are not dry

32
Q

Condom Cath

A

Is what it is

Decrease risk of infection

Not fool proof

33
Q

Nursing Care: Catheter Care

A

-Regular Perineal care (Peri-Care)

-Provide catheter care or baths per hospital protocol

-Secure catheter to prevent pulling or movement

-Empty drainage bags when it is 1/2 full

-Do not allow the bag to touch the floor

-Maintain a closed drainage system

-Timely removing

34
Q

Before Catheter Insertion and While Indwelling

A

Peri-Care (Front to back) (Do not spread E-coli)

Males: Uncircumcised

-Can be delegated to nursing assistant or patients

-CHG wipes with bath and Castile wipes Q12 prn

35
Q

Post-Catheter Removal

A

-At risk for urinary retention.

-If have not voided in 6 hours then assessing and bladder to scan to see if there is retention

-Greater than 400 preform in-out cathereization

36
Q

Lower UTI

A

-Dysuria

-Frequent Urge

-Cloudy Urine

37
Q

Upper UTI

A

-Back pain

-Fever

-Chills and shivering

-Confusion

-NVD

38
Q

Incontinence is often multifactorial

A

Nur 333 Fun 2 (19 decks)

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